Eating Disorders (3) Flashcards
Anorexia Nervosa:
What BMI do they have?
What are some of the behaviours they do that leads to weight loss?
What is a key characteristic that these pts have?
➊ < 17.5 kg/m2
➋ • Dietary restriction
• Over-activity
• Self-induced Vomiting
• Laxative misuse
• Diuretic misuse
➌ Psychopathology - Irrational fear (phobia) of normal body weight
What are the features theses pts have?
• Endocrine dysfunction – Low Sex hormone levels (FSH/LH/Oestrogen/Testosterone), Secondary Amenorrhoea, Menstrual irregularity, Loss of libido
• Hypotension
• Bradycardia
• Hypokalaemia
• Cardiac complications – Arrhythmia, Cardiac atrophy
‣ In anorexic pts, they’re body begins to take muscle from many organs for energy e.g. heart, gut (Constipation), muscle
• Osteoporosis
• Lanugo hair (fine hair covering skin)
• Mood changes, anxiety, depression
What occurs in Severe and Enduring Anorexia (SE-AN)?
After 7 years, it becomes:
• Persistent – If starvation is less marked, the psychopathology remains, w/o any periods of remission of psychopathology
• Resistant to change
• Severe – Mixed feelings about change, Ego-synchronically attached to low weight, and Behaviour/beliefs/emotions are in harmony with the illness and not reality
What’s the aim of management?
→ What complication could occur here? Why does this happen?
Get to a normal weight
→ Intake shouldn’t be resumed too quickly as it can lead to Refeeding syndrome – Rapidly increasing insulin leads to shifts of potassium, magnesium and phosphate into cells
Bulimia Nervosa:
How does it differ from Anorexia Nervosa?
What is it highly associated with?
➊ • Often have a normal BMI – body weight tends to fluctuate
• Lack of Psychopathology i.e. no irrational fear of normal body weight
• Has a later onset
➋ PCOS
What are the clinical features of it?
• Binge-eating - Eating binge foods very quickly whether hungry or not and person eats in a “dazed state” – They eat to a point of being uncomfortably full
• Purging – Pt wants to undo all the “damage” from their binge via vomiting, laxatives, diuretics, fasting
• Normal weight but major fluctuations
• Low self-esteem
• Self-evaluation unduly influenced by body-shape & weight (BUT no phobia)
• Lack of control
• Anger, anxiety & depression
What are the physical features of it?
• Teeth erosion, Alkalosis, Mouth ulcers, Swollen salivary glands – Due to recurrent vomiting
• Russell’s sign – Calluses of knuckles where they’ve been scraped across teeth to induce vomiting
• Gastro-oesophageal reflux and irritation
